Dr. Stephen Linton, founder of the Eugene Bell Foundation, says his group’s program to combat multidrug resistant TB (MDRTB) has cured its first patients after four years of working to establish adequate care in the North.

“We’re making progress,” Linton, 60, said in a phone interview. “It has been a tremendous learning curve for the North Koreans on a very short time frame. It takes most nations decades to put together a good MDRTB program because the treatment is so intensive.”

A growing health concern worldwide, MDRTB emerges when regular TB is inadequately treated, creating bacteria resistant to first- and sometimes second-line drugs. Half of those who do not get treatment, which can take up to two years to complete, die.

The problem is compounded in poor countries not properly equipped to diagnose the disease and where malnutrition makes the body more susceptible to TB.

The organization’s hopeful outlook follows its most recent trip to the North in November last year, when it found a steadily-increasing rate of patients testing negative for the strain ― meaning they are no longer infective.

It also comes as the international community wrestles with how to help the impoverished country ― which has called in recent weeks for humanitarian assistance ― without supporting its provocative behavior.

In the case of treating MDRTB, the doctor says the breakthrough would be impossible without meaningful contributions on both sides of the tense border that divides the Koreas.

Powerful medicine

By 2007, Linton had been travelling to the North to treat TB for more than a decade, so he was braced for the news when caregivers complained that first-line drugs were not helping some patients.

“I knew it was going to be a real headache,” he said of the undertaking. “But the commitment of our donors and the desire to treat the people in most need ― that was a powerful incentive.”

Later that year, Linton and his team took sputum from 19 patients, brought the samples to a South Korean hospital for analysis, and returned six months later with medicine. On subsequent trips, the number of patients wanting the test grew.

By 2009, as an indication of the worsening health situation but also the growing trust in the program, Eugene Bell was overwhelmed by crowds of people at its testing centers.

The program now accommodates upwards of six hundred patients at six specialized centers across the country’s northwest.

Linton, who spent his childhood in South Korea, says the process requires significant “buy-in” from North Koreans, beginning with the health authorities.

In their biggest show of cooperation, the government agreed to Eugene Bell’s recommendation that treatment take place in centrally-located MDRTB centers, despite reluctance over the logistics.

It also needs the dedication of health care providers, who must vigilantly keep patients on their programs. If not, they can become resistant to MDRTB medications, opening the door for the emergence of XDRTB, which Linton calls “virtually incurable.”

But the biggest commitment comes from patients, who are prescribed with a harsh cocktail of drugs. Some need to learn to trust outside help, not always an easy task in the isolated country.

“This is a very rigorous and rough treatment program. It takes a lot of very strong, toxic medicines to treat MDRTB. Patients suffer a good bit,” said Linton, who counted nausea, vomiting, temporary deafness and psychosis as side effects.

If after eighteen months, a patient’s sputum tests negative for MDRTB, they are effectively cured. But if after a year they still test positive, the treatment is considered a failure.

“Most of those people know, because they are still coughing up phlegm,” the doctor said. “But failing people is terrible. This work can be very dramatic at times.”

One Response to “Eugene Bell foundation fighting tuberculosis in DPRK”

Just for everyone’s interest, there is an interesting podcast available on Stanford’s 1:2:1 website called something akin to ‘Treating TB in North Korea’. It is the above mentioned Sharron Perry and is worth a listen.